The International Diabetes Foundation (IDF) define metabolic syndrome as follows:
For a person to be defined as having the metabolic syndrome they must have:
Central obesity (defined as waist circumference ≥94 cm for Europid men and ≥80 cm for Europid women, with ethnicity specific values for other groups) plus any two of the following four factors:
                raised triglyceride (TG) level: ≥150 mg/dL (1.7 mmol/L), or specific treatment for this lipid abnormality        reduced high-density lipoprotein (HDL) cholesterol: <40 mg/dL (1.03 mmol/L*) in males and <50 mg/dL (1.29 mmol/L*) in females, or specific treatment for this lipid abnormality        raised blood pressure (BP): systolic BP≥130 or diastolic BP≥85 mm Hg, or treatment of previously diagnosed hypertension        raised fasting plasma glucose (FPG)≥100 mg/dL (5.6 mmol/L), or previously diagnosed type 2 diabetes        
If above 5.6 mmol/L or 100 mg/dL, oral glucose tolerance test (OGTT) is strongly recommended but is not necessary to define presence of the syndrome.
While the pathogenesis of the metabolic syndrome and each of its components is complex and not well understood, central obesity and insulin resistance are acknowledged as important causative factors.
Adiposis dolorosa, or Dercum's disease, is a rare progressive condition characterized by multiple, painful, subcutaneous lipomas that usually occur in obese, postmenopausal women (Dercum FX. Three cases of a hitherto unclassified affection resembling in its grosser aspects obesity, but associated with special symptoms: adiposis dolorosa. Am J Med Sci 1892; 104:521-35, incorporated herein by reference in its entirety).
Apheresis is a treatment used for depletion of blood components, such as antibodies, low-density lipoproteins (LDL) and blood cells. Leukapheresis is the apheresis treatment used for removal of white blood cells, leukocytes. The patient is connected to an extracorporeal blood circulating system; the blood is drawn from a vein in one arm, passed through a column device and returned into the other arm of the patient. WO2010/029317 describes apheresis columns useful for treating inflammatory conditions including a chemokine immobilised on a solid support.